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Journal of Biomedicine and Biotechnology
Volume 2011 (2011), Article ID 807929, 8 pages
Research Article

Comparison of Cell Proliferation, Protein, and Glucose Metabolism in Musculoskeletal Tumors in a PET Study

Mei Tian,1,2,3 Hong Zhang,1,2,4,5,6 and Keigo Endo2

1Department of Nuclear Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
2Department of Nuclear Medicine and Diagnostic Radiology, Gunma University School of Medicine, Maebashi, Gunma 371-8511, Japan
3The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
4Zhejiang University Medical PET Center, Hangzhou, Zhejiang 310058, China
5The Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, Zhejiang 310009, China
6Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, Zhejiang 310009, China

Received 29 December 2010; Revised 19 March 2011; Accepted 25 March 2011

Academic Editor: Zhen Cheng

Copyright © 2011 Mei Tian et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


11C-choline and 18F-FAMT are known to correlate with tumor cell proliferation and amino acid metabolism. We investigated the ability of 11C-Choline and 18F-FAMT PET in diagnosis of musculoskeletal tumors in thirty-six patients in comparison of 18F-FDG PET. 11C-Choline and 18F-FDG PET were positive in all the malignant tumors ( 𝑛 = 1 3 ), whereas 18F-FAMT was positive in 11 tumors. The mean SUVs for malignant tumors were significantly higher than those for benign lesions in all three tracers imaging. A moderate correlation was found between 11C-Choline and 18F-FDG ( 𝑟 = 0 . 5 4 0 , 𝑃 < . 0 5 ), or 18F-FAMT and FDG ( 𝑟 = 0 . 5 9 6 , 𝑃 < . 0 5 ). The diagnostic sensitivity and specificity for malignancy were 91.7% and 71.4%, respectively, using 11C-choline with a SUV cut-off of 2.69. The sensitivity and specificity of 18F-FAMT for malignancy were 66.7% and 85.7%, respectively, using a SUV cut-off of 1.26. For 18F-FDG, using a SUV cut-off of 2.77, the sensitivity and specificity were 83.3% and 71.4%, respectively. According to ROC analysis, the ROC curves for 11C-Choline, 18F-FAMT, and 18F-FDG were 0.855, 0.734, and 0.847, respectively. 11C-Choline PET is superior in the visualization of musculoskeletal tumors with high contrast imaging, whereas the combination of 18F-FAMT and 18F-FDG PET provides valuable information for the preoperative planning in patients with musculoskeletal tumors.